Camp Training a Hindrance for Would-Be Doctors

Ly Chansophal began his medical education at Site Two refugee camp on the Thai-Cambodia border, where he spent his mornings studying and his afternoons treating other camp residents between 1985 and 1992.

Although he completed his three-year training for a medical doctorate at Phnom Penh’s In­ter­national University in July of 2005, the government will not certify him to practice medicine be­cause it does not recognize his UN-certified medical assistant qual­ification obtained in Site Two.

“They doubt us,” 45-year-old Ly Chansophal said. “They question, ‘How did you study? You lived in the jungle.’”

Despite the fact that the 1991 Paris Peace Accords decreed that Cambodia must recognize educational certificates awarded to citizens in exile, including the refugee camps, former camp residents con­tin­ue to face what they call dis­crim­ination in the academic, professional and political worlds.

Ministries and committees have bounced the question of border camp medical training’s equivalency with in-country university edu­ca­tion back and forth for years, leaving people from the camps on the losing side of the argument, and in many cases earning low sal­aries as a result.

Ly Chansophal said that he had been rejected not only by public med­ical schools but from other institutions of higher education because the Cambodian government does not recognize his UN-recognized credential. So when he was accepted to International University on the basis of his UN certification, he saw it as his last hope to become a recognized doctor.

Health Minister Nuth Sokhom wrote on April 5, 2005, to Interna­tional University—the only private school certified to issue MDs in Cambodia—requesting that it accept border camp-certified medical assistants as fourth-year medical students in its six-year program.

He also wrote on Aug 25 to the Ministry of Education, specifically requesting that Ly Chansophal’s credentials be accepted.

Ly Chansophal said he had been chosen as a test case and a student representative for other people educated in the border camps.

However, Minister of Education Kol Pheng replied on Nov 10 that the Health Ministry required additional training for people who studied in border camps to gain equivalency with in-country, university-educated professionals. In Ly Chansophal’s case, that would be 18 more months of study.

Arlys Herem, who was a medical assistant trainer at Site Two from 1986 to 1990, said that equivalency was theoretically established for the UN medical certificates. But the medical assistants were never properly registered inside Cambodia because the planned re-registration of all health professionals in the 1990s never happened, Herem added.

All camp-issued certificates were essentially voided in 1997, when the Ministry of Education stopped issuing certificates of equivalence following the discovery of some 30 al­legedly forged certificates, supposedly from border camps.

Like many camp-educated medical professionals, Ly Chansophal works for an NGO because he cannot legally practice. His employer, the Khmer HIV/AIDS NGO Alli­ance, paid half his annual $850 tuition fee for the three-year MD course.

“We spent a lot of money to study, and we get nothing from this,” Ly Chansophal said.

Prime Minister Hun Sen is sche­duled to preside over the Inter­national University graduation ceremony next month, but three graduates, because they were formerly camp-educated, won’t be able to practice medicine because of the dis­pute. Students said there are dozens more camp-trained hopefuls enrolled at the school.

International University Presi­dent Uon Sabo said his school was not involved in the dispute, having accepted the students at Nuth Sokhom’s request. He said he asked the students to each sign a re­­lease letter accepting that the government would make the ultimate decision about whether to certify them as doctors or not.

Ly Chansophal said he had never signed a release because the uni­versity began asking students to do so the year after he began the pro­­gram.

Government officials offered differing opinions as to who should re­s­olve this certification dilemma. Nuth Sokhom and Education Ministry Secretary of State Pok Than both referred questions to each other’s ministries.

“It’s a complicated issue,” Nuth Sokhom said. “It’s not the Ministry of Health issuing the diploma, it’s the Ministry of Education.”

He said students who chose to take six- to 18-month special courses held at government and RCAF educational institutes, de­signed to bring camp-certified professionals up to in-country standards, would­n’t face these problems.

Lori Dostal, who was medical coordinator for the American Refu­gee Committee at Site Two from 1989 to 1993, said the UN-certified education was excellent training for treating refugees but likely had a slightly different focus from conventional university training.

Basic science and chronic diseases like diabetes, hypertension and cancer were given less focus in the camp education, because there was an immediate need for treatment of acute rather than chronic ill­nesses.

But Dostal added that the mix of foreign and Khmer teachers and standard UN certification process gave students a quality overall education.

“I am sure that there are some holes in their training,” Dostal said. “But I’m not sure that those holes might not also be in the medical education at university here,” she said.